الفهرس | Only 14 pages are availabe for public view |
Abstract EMVs is a pathologic arteriovenous circuit that may cause life-threatening gynecologic hemorrhage They may result from previous uterine surgery including diagnostic or therapeutic curettage, cesarean delivery. Patients most commonly present with heavy or irregular vaginal bleeding after a miscarriage, uterine surgery. Historically, acquired uterine EMV was diagnosed by pathology after hysterectomy. Recently, Transvaginal ultrasound is the initial imaging study of choice for abnormal uterine bleeding. Doppler imaging is imperative to the diagnosis. The presence of a tubular, hypoechoic structure in the myometrium by grayscale ultrasound imaging, although common, is not specific for uterine EMV. The identification of uterine high velocity blood flow with low impedance by Doppler ultrasound is highly suggestive for a uterine EMV. The outcome of this study is to detect the Incidence of EMV/AVMs among female patient who have undergone D&C in Menoufia University Hospital by using color flow Doppler ultrasonography. This study included 107 patients in childbearing period presented to outpatient clinic or emergency room with abnormal uterine bleeding and after D&C were followed up to detect acquired EMVs. The patients presented by different complains but the most recorded complain was vaginal bleeding due to abortion ,others referred due to dysfunctional uterine bleeding not controlled by Summary 70 medications ,other patients 2ry postpartum hemorrhage then D&C was done. All participants were subjected to full history taking, complete clinical examination lab investigation. Transvaginal ultrasound grayscale imaging was done showing myometrial heterogeneous hypoechoic tubular structure in 34 patients and homogenous texture in 73 patients. Color flow Doppler ultrasound was applied on the suspected lesions detected by 2D US gray scale showed that high velocity blood flow within the vascular “web” with high PSV and low resistance index in 24 patients, suggesting acquired EMVs. |